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Four-corner arthrodesis with a radiolucent locking dorsal circular plate: technique and outcomes

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HAND

Abstract

Background

Scaphoid excision and four-corner arthrodesis (FCA) is an acceptable motion sparing procedure used to treat wrist arthritis. Recently, a locking dorsal circular plate composed of polyether-ether-ketone has been introduced (Xpode®; TriMed Inc.). The purpose of this study is to assess the efficacy of this specific plate design with regard to FCA.

Methods

A retrospective chart review of all patients who underwent FCA with an Xpode® between January 1, 2008 and December 31, 2012 was conducted. Patients were contacted and asked to return to clinic for clinical and radiographic follow-up. Patient demographics, range of motion, grip strength, and complications were collected from medical records. Patients completed a patient-rated wrist evaluation (PRWE). A paired t test was used to compare means, and p values <0.05 were considered statistically significant.

Results

Twenty-six procedures (24 patients) were identified. One patient required full wrist fusion following the initial procedure. Of the 25 remaining wrists, arthrodesis was successfully achieved in 20 (80 %). Eleven patients (13 wrists, 52 %) returned to clinic for an average follow-up of 28 months. Mean wrist extension improved from 30 to 47°, and flexion decreased from 33 to 23°. Average grip strength was 77 % of the uninjured side. The mean PRWE scores for pain and function were 19.7 and 17.1, respectively. Five patients underwent additional operations (two hardware removals, two contracture releases, and one distal radial ulnar joint arthroplasty).

Conclusions

FCA with the Xpode® yielded reasonable results for pain and function and demonstrated a fusion rate of 80 %.

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Conflict of Interest

Benjamin Rudnick declares that he has no conflict of interest.

Peter Goljan declares that he has no conflict of interest.

Jason S. Pruzansky declares that he has no conflict of interest.

Abdo Bachoura declares that he has no conflict of interest.

Sidney M. Jacoby declares that he has no conflict of interest.

Mark S. Rekant declares that he has no conflict of interest.

Statements of Human and Animal Rights

All study procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

Statement of Informed Consent

Informed consent was obtained from all patients included within the study.

Funding

No external funding was required for this study.

Disclaimers

None

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Authors and Affiliations

  1. The Philadelphia Hand Center, P.C, Thomas Jefferson University, Philadelphia, PA, USA

    Benjamin Rudnick, Peter Goljan, Jason S. Pruzansky, Abdo Bachoura, Sidney M. Jacoby & Mark S. Rekant

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  1. Benjamin Rudnick
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  2. Peter Goljan
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  3. Jason S. Pruzansky
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  4. Abdo Bachoura
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  5. Sidney M. Jacoby
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  6. Mark S. Rekant
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Correspondence to Peter Goljan.

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Rudnick, B., Goljan, P., Pruzansky, J.S. et al. Four-corner arthrodesis with a radiolucent locking dorsal circular plate: technique and outcomes. HAND 9, 315–321 (2014). https://doi.org/10.1007/s11552-014-9617-y

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  • DOI: https://doi.org/10.1007/s11552-014-9617-y

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